Tips and Accepting Them

There are many ways for a gift to be given: under a tree, at a party, in the driveway…but there is always some level of trepidation for receiving gifts, especially for me in my professional life.

I am a Licensed Massage Therapist.  There are several images that come to mind and situations where massage therapists are part of a personal health or mental regimen for a client/patient that make the MT a facilitator or procurer of better health.  There are also positions in which massage therapists are considered, for all technical purposes, healthcare providers, like in a rehabilitative or preventative sense.

Although I do not advertise that I either accept or don’t accept gratuities offered following a massage therapy session that I facilitate for my paying or non-paying client/patient, I am often confronted with what is to me, from a business standpoint, an awkward situation: receiving a tip.  To receive or not to receive?

If I accept, will it become a regular thing for this client to tip?  Well, I think I first have to ask – is this something that this client normally does (or doesn’t do, in the case this situation never happens with this client)?  I never assume that it is a habit, and much less a habit that I will strive to hope or see happen in the future – if I do, then I will be “working for tips,” which is not in my work ethic.  I charge a fair price for services rendered and only expect payment for the service as agreed upon with my client/patient.  So, what’s next?

Is this tip the result of a Pavlovian behavior pattern?  In other words: is the client/patient used to tipping massage therapists or any service professional?  Is this a behavior I want to encourage by setting a precedent of accepting the tip?

After I have decided on the nature of the tip and whether or not I should accept it without question or challenge, it may seem like the end of the story.  But let’s dive a little deeper…

Are massage therapists considered service professionals or healthcare professionals?  They are each to each clients’ needs.  If a massage therapist serves a “relaxation” purpose, or the clients’ expectations are for “relaxation” – usually resolve for a mentally-stressful situation – then I see a massage therapist as a service professional.  If the purpose is to rehabilitate, prevent, or maintain good health (like in a program), then I see a massage therapist as a healthcare professional.

Next question: is it appropriate to tip service professionals?  Yes, societal practice and situational results encourage a sense of gratitude that is often expressed in an economic transaction – the tip: that “extra” money/gift that is given to the provider for a job done “above and beyond” the regular price paid.

Is it appropriate to tip healthcare professionals? Not always – In my experience, other-than-massage-therapist healthcare professionals focus on the altruistic nature of their work and may not consider their service to be qualified to establish an “above and beyond” ability that “service-oriented” professions often make a goal and, thus, do not expect the same behavior from their patients.  I might even go out on a limb and say that Tipping may be perceived as a capitalistic behavior and that healthcare (from an individual healthcare professional’s viewpoint) is not as capitalistic in nature.

This classification massage therapists playing the role of service or healthcare provider is a complicated one, but to me, and for the purposes of this article, let’s agree that the classifications have made a distinction in the nature of the compensation given by the client/patient.  There are certainly different roles, like each of these, that indeed a single massage therapist can fulfill.

Tipping sends a message: I appreciate you, professionally: more than you’re charging me.  When these messages are not clear is when the tipping conversation/questions comes up: I don’t know if I should tip you or not, so I will to be safe (socially-speaking); I expect a tip because I “always” give extraordinary service (from the service provider’s viewpoint); or, I do not tip my doctor so why should I tip you (or expect a tip, from a healthcare provider’s viewpoint)?

My policy, no matter if I’m playing the role of service or healthcare provider, has always been “Tips are never expected, but always appreciated.”

Do you want to refuse a tip more than once? – you can be a staunch supporter of the work ethic that says: it’s too weird to accept more pay that I have already agreed to.  There are boundary issues that may be important to you to avoid with the implication that a client/patient may gain some “advantage” in the client-patient/therapist relationship.  I suspect that that is the main reason for healthcare providers’ “no tipping” policies, and definitely respect it.

Do you want to have a “no tipping” policy?  – do you make it clear, prior to the session, that “tips are not accepted”?  This may precipitate a rogue tipper or two (to actually tip, despite policy), but that would be the most-professional (and likely –effective) way to create the expectation of your client/patient.

In my practice, I do not speak of tipping – when asked, I state my policy “never expected, always appreciated”…so why do I “not talk about tipping”?  I believe it is a personal choice, and not one that I have or want control over.  When I am offered, I accept based on the role I am playing: service or healthcare provider, and often after I have refused.

Here are a couple of examples of my First Refusal:

  • “Thank you so much for the thought: I really appreciate it, but why don’t you use it for your next massage [or a massage package] – when do you want your next massage?”
  • “Thank you so much – tips are not necessary.  I appreciate your commitment to massage therapy – may we apply that to your next massage?”

Here a couple ways I practice humility when receiving a tip after refusing it once:

  • “Thank you so much for your tip – I will be donating this to [name of cause]__________ as part of my contribution to community/non-profit activities that I believe in.”
  • “Thank you so much for your tip – I will be investing in furthering my expertise in massage therapy for you and all of my clients/patients in ____________________ class I’m registering for [soon].”

I think to refuse a tip offered more than once would be insulting to the client/patient and would also be a form of self-sabotage: to not consider that I am good enough to be paid “more than” what I am charging.  Obviously, that client/patient thinks I should be charging more than I am for my service/healthcare.

If you don’t like accepting tips, why not consider increasing your pricing?  That may be the message you are hearing but not heeding.

If you like accepting tips, the excellent service you provide daily may go unnoticed by some (and already-expected by some) and greatly-noticed and appreciated by others – “Up” your game by trying new customer service techniques that not only set you apart from other practices, but also put you in a class of your own.

Where do you stand on tipping/gratuities?  “To Tip”, or “Not To Tip”?

39 thoughts on “Tips and Accepting Them

  1. I like this discussion, David, I think you really cover all the angles here. I love the script you give to deflect tips, too!

    As a customer, I’ve always felt awkward about tipping, I am SO NOT COOL when trying to slip a doorman a Lincoln. I chose to institute a firm No Tipping policy for that reason. I never wanted my clients to feel awkward. Also, I want my clients to treat regular massage as part of their wellness care, not as a luxury service, and I’ve felt that a No Tipping policy reinforces that. Occasionally I’ve had a client insist on tipping me anyways, and I’ve tried to be gracious when it occurs.

    I love your approach, and I think it’s a great foundation for people to create a system that works for them.

    • Thanks for your comments, Allissa – the boundary issue is always a consideration for me. I truly appreciate tips and have always felt that maybe, in some way, the tip may turn into a leverage issue…for “the next session.” There are few cases where tipping has allowed, for me, exceptions to strictly enforcing my policy. As “wrong” as it may seem, let me give you the only example I can admit to: when a client reschedules outside of my stated “no less than 24 hour” policy – if they are a tipper (no matter the %), I usually find a way not to charge them for the rare occasion that I, technically, need to enforce that policy. And it’s because they have “paid” in a way, before, that cancellation fee – I guess, in essence, applying their previous tip to their account (balance) as a “fee paid.”
      I think this is why, for me, accepting a tip is trepidacious – don’t want to make exceptions stated policy, but will where it makes what-I-perceive-to-be good business sense.

  2. For the sake of my bank account, I whole-heartedly accept tips.

    I work in a hair salon where tipping is expected, yet a good number of customers (for both the stylists and massage therapists) either under-tip or don’t tip at all.

    I get paid an hourly wage, so I get paid whether a client shows up or not. It’s still not enough to cover my living expenses. I depend on tips to make up the difference. And when the tips aren’t there… well…

    Let’s just say I’m considering going back to retail. (*gag*)

    • NOOOOOOoooooo! Don’t go back to retail! 😉
      In my travels as an employee, I’ve seen some really good, ethical ways to collect a tip…and some not so ethically sound, but made perfect business sense, like in the case of “under-tipping.”
      Please forgive me for having a hard time grasping the concept of “under-tipping”, based on my tipping philosophy in the article – I just think any tip is a good tip. Here’ are a couple examples of how you might collect a tip more regularly, as is often the case in retail businesses here in the resort destination of Las Vegas:
      There is a fashion of getting that gratuity called “auto-gratuity.” This line item featured on the final bill notes and adds a percentage of the retail pricing to the final bills that, according to the retailer in many cases, is a “convenience” for the guest/customer. Maybe, through your scheduling or billing software, your salon can add on gratuity to each bill – the policy also, in the places I’ve seen the auto-gratuity, states payment is not required of this auto-gratuity, so if the guest/customer refuses to pay it, it’s OK. Policy is clearly stated in the retailer’s menu/ads as well, so the tipping questions rarely come up.
      Personally, I do not run my business in that way and believe that gratuities are earned “after the fact” and never presumed, like with the method described. However, this method can be a way to educate the guest/customer of the business where the service providers do not collect 100% (often, 20-50%) of the retail pricing and cannot raise their pricing to accommodate built-in gratuities that are passed on to the service provider.
      I’ve also seen, in a retail service environment, the bill be presented by the service provider, to include a “tip/gratuity” line – the guest/customer completes the service charges just for that provider and can write in, on the line provided, the charge to their account that represents the tip for that provider. This also takes the awkwardness out of the guest/customer’s hands when they go to settle the bill for all their services and believes one person should get more than the 20% that they are leaving for all the providers.
      Thanks for your comments, Bethany – this is ALWAYS a hard topic to discuss: there are so many possibilities! :)

      • Oh, man. Even if our salon had scheduling software, my boss wouldn’t use it. (She’s not really a Luddite, just… lacking the knowledge.) We do at least have a tip line on our credit card slips, so that’s working.

        When I say under-tipping, I mean I once got a $5 tip for a two-hour massage plus hot towels and aromatherapy. I busted my glutes but didn’t make much of a commission off of it, so I felt let down.

        I certainly agree with you and some of the other comments that tips are never required but always appreciated, especially if I go over and beyond in a session. I try to keep things in perspective — there have been times where I didn’t tip because I didn’t know the policy (i.e. my chiropractor’s office) or because I just didn’t have the extra cash. I try to educate others and remind myself that times are tough all over.

  3. Say “Thank You” and accept all the good that comes to you, let others give to you in appreciation (it’s a joy for them), and the less you worry about it the less it will be a problem.

  4. “Are massage therapists considered service professionals or healthcare professionals? They are each to each clients’ needs. If a massage therapist serves a “relaxation” purpose, or the clients’ expectations are for “relaxation” – usually resolve for a mentally-stressful situation – then I see a massage therapist as a service professional. If the purpose is to rehabilitate, prevent, or maintain good health (like in a program), then I see a massage therapist as a healthcare professional.”

    Please pardon the super-long quote, but I want to make as much sense as I can here. 😉

    For me, these categories are intermingled beyond recognition. I subscribe to the Danny Meyer view that “Service is the technical delivery of a product. Hospitality is how the delivery of that product makes its recipient feel.” Why should service and hospitality be left in the hallway outside the clinic doorway? Isn’t the seamless delivery of a product (or service) and the thoughtfulness involved in the process the first step toward stress-reduction? Isn’t stress-reduction a health benefit one can reap from massage?

    As service, hospitality, and healthcare are not mutually exclusive in my world view, I also see so much overlap between the “service” and “healthcare” aspects of what we do. This is a debate that won’t be vacating the arena any time soon, and I’m sticking with “we’re both”. If you want to tip me, that’s cool, and thank you very much! :)

    (And to be clear, in a spa or salon environment, not tipping your service provider is bad form — unless they specifically forbid or clarify it via tipping policy — in case there was any question. When in doubt, I find I usually feel better when I err on the side of generosity.)

    • Totally agree, Andrea – well stated. Please consider my use of “service” provider to have a business and hospitality feature built in. I separated healthcare provider as a type of business model that operates in the same professional sense but of a different mindset when it comes to how the business/hospitality is delivered. (huh-huh: I said “hospital”-ity. huh-huh-huh…)
      Does your Meyer reference open a discussion to establish what is often referred to as “bedside manner” in the healthcare business model for massage therapists? Are healthcare models of hospitality transferring hospitality stereotypes onto massage therapists that consider themselves “in the healthcare field” or are massage therapists counter-transferring into those healthcare models when relating to the traditional (or, what-has-been-known-as the) massage therapy industry?
      Professionally, you are right on the money – essentially, all contemporary massage therapists are trained to do the same service, to include the same benefits across business models…

      • Hospital-ity! 😀

        I think bedside manner would be part of the hospitality equation, but not the whole. I also think the level of hospitality offered in a “healthcare massage” setting would depend greatly on the MTs involved. Do they place a high level of importance on the hospitality aspect of their position? Do they strive to be as adept in the hospitality realm as they do in the realm of physical massage techniques?

        Good discussion! I usually don’t have this much to type in the comments section! 😉

        • good Qs, Andrea – “would depend greatly on the MTs involved” brings us back to center: in either case, retail or healthcare massage, the nature of the hospitality/bedside mannerism depends on the MTs themselves, not the stereotypical perception. There are just as many non-hospitality-oriented retail MTs as not, and I only can hope that I find the compassionate and tip-worthy one in each model when I get a massage :)

  5. “Never expected but always appreciated” is my motto as well. I live and work in an up-and-coming neighborhood with lots of young professionals, and they make up the bulk of my clientele. I try to keep my prices on the lower side so that my services can be more affordable to these people. If they can afford a tip on top of it and wish to give me one, I am very grateful. If not, I don’t hold it against them- I’m one of those young professionals myself!

    • Love your point-of-view, Sonia :)
      There is something very liberating about having no expectations beyond “the deal” – for me, it frees my mind to listen to the body with which I am working and have a clear path…

  6. I’m not sure why people have to pick things apart down to the tiniest minutiae… It’s a tip… Maybe the giver was blessed by your massage and wants to show appreciation… I take the viewpoint that the entire massage experience for each of my clients is not about me… But about them… If they want to show their appreciation by tipping, I won’t make a big deal by refusing the tip and somehow sending them the message that I’m some sort of massage martyr…… If its that much of dilemma for you… Maybe you could put the tips in an envelope and either donate them to a cause that is near and dear to your heart at the end of the year without taking the tax deduction, or you can put it aside and provide the equivalent in free or discounted massage to clients with limited means…. If you’re uncomfortable accepting tips, don’t make your clients feel awkward by making a big deal about it.. Just graciously accept it and find a way to pay it forward…

    • Thanks for you reply, Jenn!
      For me, introspection leads to awareness, which I believe helps me make “better” decisions, leading to happiness. Fairness is something I strive for, although not always completely achieved. Critically looking at a topic can help make better policy and forums such as this lend themselves to a more omniscient realization of “what works.”
      I love simplicity and settling in with opinions about what crops up from time to time – especially regarding this blog entry – as a business and ethical concern is the goal.
      I really like the “pay it forward” concept – I am beginning to believe that that is a common characteristic in massage therapy professionals! :)

    • ooooooo – good one, Scott.
      like a box of chocolates, life has a variety of ways gratuity can be given/expressed. To me, gifts at Christmas (or any holiday important culturally, socially, or to the specific client) carry the same implications as gifts [of gratuity] at any other time of the year.
      Maybe: “what is considered ‘reasonable’?” might be a good question, too…
      What if your client/patient gave you a $1,000 check as a gift/gratuity? Would you accept?
      Is the check the same as a hand-crocheted hat?
      If you are friends with the client (in a dual relationship), is the gift in relation to the service you provide OR a personal offering?

  7. Great article! I used to accept tips until I read an article, somewhat like this one, many years ago that changed my mind. Instead, I also suggest the client use it towards their next appointment. At Christmas time, my clients give me gifts of money that I don’t count as a tip.

    Since I am a sole practitioner, I have the luxury of not accepting tips. I also keep my rates in the upper median range of my competition, so I don’t need tips. Many clients have thanked me for not accepting a tip even though they can well afford it. If a client presses the issue, I will accept the tip because I don’t want it turning into some kind of control thing that goes back and forth.

    When I get a massage, I will leave a tip if the service is outstanding. I also tip if the massage therapist isn’t a sole practitioner and depends on tips for income, such as in a day spa, only because I’ve worked in a variety of environments and know the spa culture well.


    • I like your methodology, practice, and administration…not to mention the philosophies you outline – “paying it forward” (especially considering where you’ve/we’ve been) comes to the front of the line again: being aware of and trying to be fair to those practitioners who practice in places where tipping is not common by tipping “for sure” is a great example of being aware. We are clients, too! Spreading the wealth evenly and especially in the case where talent is found and recognized (through a tip) is exactly the reason I love this topic.
      Thanks, Rajam, for helping me remember that some practitioners, no matter where they practice, deserve recognition and respect when sometimes the best, fairest way to do that is through “paying” it forward.

  8. I am of the opinion that there is no greater compliment you can be given as a professional, than someone deciding to tip you above and beyond the cost of the service you provided them. I have never required that a person tip, however…. I have seen people be quite offended if I didn’t graciously accept their gratuity. Even culturally for some, you run the risk of insulting someone that has gone out of their way to demonstrate their appreciation.

    • Good points, Larry – I think it comes down to that “gut feeling…” Only the practitioner knows what is right and what is wrong (and what is just plain weird) in their set of personal AND professional values…and their clients’ 😀

  9. Great article and comments. I’m currently looking at this issue for my own practice and there really is no clear-cut right or wrong solution as long as you’re respecting your clients as well as your own boundaries when formulating your policies and practices.

    I agree with Andrea that the realms of the service and healthcare side of what we do overlap and are not at all at odds with each other. In regards to “relaxation”- as someone familiar with mental health issues I can say that many times clients need the relaxation benefits of massage because of the physical effects of their psychological condition. The brain is, in fact, a part of the physical body and sometimes can adversely affect it in even greater ways than overuse or physical strain can. For many people self-care is even harder because of depression or fatigue so massage can be an integral part of their healthcare plan.

    If we really looked hard at how we are viewed not just by the public, but by the governing agencies that regulate what we do we would probably see that we are more of a “skilled trade” than healthcare professionals. 500 hours here in TX is about the same as an AC repairman (eye-roll). I do not think that this perception will change until we at least get national regulation for the education and licensing of massage. In the mean time, having a “no tipping” policy, at least for those of use who control our own prices, can help move public opinion in the direction of viewing us as healthcare professionals- which is where we need to be heading.

    I personally do not tip therapists who own their own businesses and control their prices unless I feel they’ve really made an extra effort and gone the extra mile. And that’s not because I’m cheap, but because they control their prices and value their services as they and their market see fit. And because In my eyes I view them as healthcare professionals. I will always tip very well in a spa or Mega-lo Massage environment because I know how little they can make. Everyone should tip these therapists generously.

    Another view that I haven’t heard expressed is from a marketing angle. I’m in this business but as a client even I can get confused or frustrated not knowing if the therapist is expecting a tip. Usually if they have a sign that reads “Gratuities are not required, but greatly appreciated” it makes me think they still want one for some reason. It’s just a weird mental block that I know a lot of people experience. So when I schedule an appointment I am always thinking “is this massage really going to cost $60, or do they expect another 15-20 dollars”…

    Imagine being on the high-middle range of rates in your area with a no tipping policy that you can use as a draw for potential customers so they can know for sure that your rates are what they are and there’s no expectation of a tip. At least from my experience as a client saying that you accept tips but don’t expect them is still somehow cloudy. Maybe that’s just me, but I’ve got a feeling that it isn’t. I would refer clients who really want to tip to either apply it to their next session, say that it will be donated to a local charity, or offer them a free chair massage. But I’d much rather have them come in again and refer their friends than get a little extra green. Just my opinion :)


    • excellent, and well-thought-out, Michael – I’d like to say, particularly, that I like that you brought to my attention the order in which it’s stated: “Gratuities are not required, but greatly appreciated.”
      Methinks reversing that order might make you think (conversely) that the therapist is therefore “not expecting a tip” if they say “Tips are greatly appreciated, but not required.”
      It seems I [also] hear “the last thing” someone says to me…in a series. :)

  10. Pingback: Tips and Accepting Them - West Hartford Massage Spot

  11. When I was on my own, seeing my clients with my own marketing etc, I rarely got tipped. Which was fine because I was in control of my own overhead. Since then, I have had instances where I have worked in a Salon or Spa environment, and tips were greatly appreciated since I did not get to “keep” all of the income. So, I think it is both personal preferance of the practitioner, and it depends on where you work. :)

    • true, Donna – i think there is some sort of Karma Kap on what *a person’s work* is worth – what *the person* is worth may be reflected (or transferred) in the opinion of the client via “the amount of tip” one would like to leave. Another factor in the amount of tip: Realizing a practitioner is in control of (a smaller percentage) the profit from service income is a rare case with most clients in a spa/establishment situation…but much more common an understanding in a private practice where the client is well-aware of the income impact of an independent/small business…would you agree?

  12. I have gotten comfortable with people placing their own values on services provided them. When I’m ask I usually say it is never expected as I feel I charge an appropriate amount and I work for myself. When I’m the paying costumer I tip those who work for others, waitresses, spa services, etc. I do sometimes tip my Marriage and Family counselor, I don’t really consider it a tip as an intuative alignment of compensation for a great session.

    Blessings, Cindy

    • I like the idea of the amount of compensation [for service-oriented products] as “intuitive alignment” – that’s awesome, Cindy!
      Who’s that guy – Jon BonJovi? – who opened a donation-only restaurant: no set prices (but suggestions for “$10” per meal) – he can afford to give it away…and somehow his celebrity and generosity (willingness to let a few people take advantage of him or even justifiably get the food they need to live, without cost) pave the way for what-I-think-you’re-talking-about in the “intuitive alignment” of those who can afford it to pay…and maybe even a little more :)

  13. I work at a wellness center with chiropractors, acupuncture and massage. We have the sign that tips are not expected but graciously accepted. A big reason we put up the sign is because people would ask the chiropractors if they could tip, putting everyone in an awkward position. I get tips from about 40% of the people. I never expect it because of the more medical setting than a spa or hair salon. But, I would like to make the point that if you look at massage therapist as a healthcare provider, then you must realize that we get paid no where near what the Docs, nurses, PT’s etc. get paid and we spend 3-4 times longer with the client/patient. For this reason, I have no problem accepting a tip.

    • good observation, Lori – I like that you equate the quantity of time with the occasional expression of gratitude through tipping. Some patients realize (wanting to show their realization and appreciation) and some don’t. it sounds like you’ve already accepted that your in an environment where the prevailing attitude (whatever it may be “today”) from the Providers operationally determines the way you practice accepting tips (in this case)…and that they are flexible, too. bravo!

  14. I think clarity of policy is best, and that clarity must come from what I most feel comfortable with, not what everyone is doing. I think that if a client chooses to tip and I accept the tip, I must be sure that this does not loosen any boundary I have with them. For example…A tipper who, it turns out, is often late for their appointment: Do I stay longer or stop at the scheduled time? Do I say something to them about their lateness or let them slide? In other words, does their tipping cause me to feel obligated outside of policy or standard I hold for myself and my practice? Do I now find myself in an uncomfortable position? If so, I expect my client could be, too (not knowing what to expect from me). Plus, I’m supporting behavior that is unacceptable. Clarity, my personal “line in the sand,” and sticking to it is key. It’s self-caring.

    As far as holiday gifts, I graciously accept, and send a thank you note, too.

    • Agreed, Brianne: having a policy helps clarify not only for the client, but for the practitioner as well. and policies are written by the practitioner, at their pleasure – policies can change, and should, depending on the practitioner’s values and good business sense.
      Great considerations you brought up! :)

    • thanks for your comments, Tracie – working from a space of gratitude in service makes discussions like these worth thinking about! 😉

    • I think the longer we each are in practice, there is a (sometimes: unrecognized?) shift in how we practice – what we believe, how we bring it to life through our policies, written and verbal. If/When there is a shift – to which the “should” refers, because I believe it is inevitable 😉 – then the policy will change. I think it’s good to be aware internally (as a matter of belief) and make it known externally (through Client Policy Statements)

      Kind of like the purpose of a formal business plan: it is meant to be a living document, revisited from time to time and updated to reflect the current “business ideas/plans” – in writing.

      Does that help, Brianne?

Leave a Reply